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Erschienen in: Zeitschrift für Gerontologie und Geriatrie 2/2013

01.02.2013 | Beiträge zum Themenschwerpunkt

Depression beim gebrechlichen Alterspatienten

Diagnostik und Therapie

verfasst von: D. Kopf, J. Hummel

Erschienen in: Zeitschrift für Gerontologie und Geriatrie | Ausgabe 2/2013

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Zusammenfassung

Gebrechlichkeit erhöht das Risiko einer depressiven Störung. Der vorliegende Beitrag gibt eine selektive Übersicht zu den Fragestellungen Koinzidenz von Depression und Gebrechlichkeit, Symptomatik, Diagnostik und Therapie der Depression bei gebrechlichen Menschen. Depressive Störungen im höheren Lebensalter sind durch eine zunehmende Häufigkeit und Intensität von somatischen Symptomen geprägt. Diese Symptome überlappen mit einigen Kriterien der Gebrechlichkeit. Beide Störungen weisen ein erhöhtes Risiko für eine Verschlechterung der körperlichen und seelischen Gesundheit, für Heimeinweisung und für Tod auf. Die Erfassung subsyndromaler depressiver Störungen bei gebrechlichen Menschen ermöglicht Perspektiven der Prävention. Bei präventiven und therapeutischen Maßnahmen ist besonderes Augenmerk auf Therapiesicherheit sowie einen barrierefreien Zugang zu Therapieangeboten zu legen. Da körperliche Begleitsymptome das Risiko einer Verschlechterung der Depression bedingen, müssen sie gemeinsam mit den psychischen Symptomen in einem fächerübergreifenden geriatrisch-gerontopsychiatrischen Therapiekonzept behandelt werden.
Literatur
1.
Zurück zum Zitat Blumenthal JA, Babyak MA, O’Connor C et al (2012) Effects of exercise training on depressive symptoms in patients with chronic heart failure: the HF-ACTION randomized trial. JAMA 308:465–474PubMedCrossRef Blumenthal JA, Babyak MA, O’Connor C et al (2012) Effects of exercise training on depressive symptoms in patients with chronic heart failure: the HF-ACTION randomized trial. JAMA 308:465–474PubMedCrossRef
2.
Zurück zum Zitat Braam AW, Prince MJ, Beekman AT et al (2005) Physical health and depressive symptoms in older Europeans. Results from EURODEP. Br J Psychiatry 187:35–42PubMedCrossRef Braam AW, Prince MJ, Beekman AT et al (2005) Physical health and depressive symptoms in older Europeans. Results from EURODEP. Br J Psychiatry 187:35–42PubMedCrossRef
3.
Zurück zum Zitat Burkhardt H, Wehling M, Gladisch R (2007) Prevention of adverse drug reactions in older patients. Z Gerontol Geriatr 40:241–254PubMedCrossRef Burkhardt H, Wehling M, Gladisch R (2007) Prevention of adverse drug reactions in older patients. Z Gerontol Geriatr 40:241–254PubMedCrossRef
4.
Zurück zum Zitat Coupland C, Dhiman P, Morriss R et al (2011) Antidepressant use and risk of adverse outcomes in older people: population based cohort study. BMJ 343:d4551PubMedCrossRef Coupland C, Dhiman P, Morriss R et al (2011) Antidepressant use and risk of adverse outcomes in older people: population based cohort study. BMJ 343:d4551PubMedCrossRef
5.
Zurück zum Zitat Danon-Hersch N, Rodondi N, Spagnoli J, Santos-Eggimann B (2012) Prefrailty and chronic morbidity in the youngest old: an insight from the Lausanne cohort lc65 +. J Am Geriatr Soc 60:1687–1694PubMedCrossRef Danon-Hersch N, Rodondi N, Spagnoli J, Santos-Eggimann B (2012) Prefrailty and chronic morbidity in the youngest old: an insight from the Lausanne cohort lc65 +. J Am Geriatr Soc 60:1687–1694PubMedCrossRef
6.
Zurück zum Zitat Dirmaier J, Krattenmacher T, Watzke B et al (2010) Evidence-based treatments in the rehabilitation of patients with depression – a literature review. Psychother Psychosom Med Psychol 60:83–97PubMedCrossRef Dirmaier J, Krattenmacher T, Watzke B et al (2010) Evidence-based treatments in the rehabilitation of patients with depression – a literature review. Psychother Psychosom Med Psychol 60:83–97PubMedCrossRef
7.
Zurück zum Zitat Ekerstad N, Swahn E, Janzon M et al (2011) Frailty is independently associated with short-term outcomes for elderly patients with non-ST-segment elevation myocardial infarction. Circulation 124(22):2397–2404PubMedCrossRef Ekerstad N, Swahn E, Janzon M et al (2011) Frailty is independently associated with short-term outcomes for elderly patients with non-ST-segment elevation myocardial infarction. Circulation 124(22):2397–2404PubMedCrossRef
8.
Zurück zum Zitat Flint AJ, Gagnon N (2002) Effective use of electroconvulsive therapy in late-life depression. Can J Psychiatry 47:734–741PubMed Flint AJ, Gagnon N (2002) Effective use of electroconvulsive therapy in late-life depression. Can J Psychiatry 47:734–741PubMed
9.
Zurück zum Zitat Fried LP, Tangen CM, Walston J et al (2001) Cardiovascular Health Study Collaborative Research Group. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 56:M146–M156PubMedCrossRef Fried LP, Tangen CM, Walston J et al (2001) Cardiovascular Health Study Collaborative Research Group. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci 56:M146–M156PubMedCrossRef
10.
Zurück zum Zitat Gogulla S, Lemke N, Hauer K (2012) Effects of physical activity and physical training on the psychological status of older persons with and without cognitive impairment. Z Gerontol Geriatr 45:279–289PubMedCrossRef Gogulla S, Lemke N, Hauer K (2012) Effects of physical activity and physical training on the psychological status of older persons with and without cognitive impairment. Z Gerontol Geriatr 45:279–289PubMedCrossRef
11.
Zurück zum Zitat Harris Y, Cooper JK (2006) Depressive symptoms in older people predict nursing home admission. J Am Geriatr Soc 54:593–597PubMedCrossRef Harris Y, Cooper JK (2006) Depressive symptoms in older people predict nursing home admission. J Am Geriatr Soc 54:593–597PubMedCrossRef
12.
Zurück zum Zitat Harris Y (2007) Depression as a risk factor for nursing home admission among older individuals. J Am Med Dir Assoc 8:14–20PubMedCrossRef Harris Y (2007) Depression as a risk factor for nursing home admission among older individuals. J Am Med Dir Assoc 8:14–20PubMedCrossRef
13.
14.
Zurück zum Zitat Hausner L, Damian M, Sartorius A, Frölich L (2012) Efficacy and cognitive side effects of electroconvulsive therapy (ECT) in depressed elderly inpatients with coexisting mild cognitive impairment or dementia. J Clin Psychiatry 72:91–97CrossRef Hausner L, Damian M, Sartorius A, Frölich L (2012) Efficacy and cognitive side effects of electroconvulsive therapy (ECT) in depressed elderly inpatients with coexisting mild cognitive impairment or dementia. J Clin Psychiatry 72:91–97CrossRef
15.
Zurück zum Zitat Hegeman JM, Kok RM, Mast RC van der, Giltay EJ (2012) Phenomenology of depression in older compared with younger adults: meta-analysis. Br J Psychiatry 200:275–281PubMedCrossRef Hegeman JM, Kok RM, Mast RC van der, Giltay EJ (2012) Phenomenology of depression in older compared with younger adults: meta-analysis. Br J Psychiatry 200:275–281PubMedCrossRef
16.
Zurück zum Zitat Hummel J, Weisbrod C, Bösch L et al (2012) Acute illness and depression in the elderly and the influence of cognitive impairment: AIDE-cog trial. Z Gerontol Geriatr 45:34–39PubMedCrossRef Hummel J, Weisbrod C, Bösch L et al (2012) Acute illness and depression in the elderly and the influence of cognitive impairment: AIDE-cog trial. Z Gerontol Geriatr 45:34–39PubMedCrossRef
17.
Zurück zum Zitat Hummel J, Weisbrod C, Mueller-Wilmsen U et al (2012) New psychosocial interventions are needed in early dementia BMJ 345:e5991 Hummel J, Weisbrod C, Mueller-Wilmsen U et al (2012) New psychosocial interventions are needed in early dementia BMJ 345:e5991
18.
Zurück zum Zitat Kerse N, Hayman KJ, Moyes SA et al (2010) Home-based activity program for older people with depressive symptoms: DeLLITE – a randomized controlled trial. Ann Fam Med 8:214–223PubMedCrossRef Kerse N, Hayman KJ, Moyes SA et al (2010) Home-based activity program for older people with depressive symptoms: DeLLITE – a randomized controlled trial. Ann Fam Med 8:214–223PubMedCrossRef
19.
Zurück zum Zitat Koenig HG, Johnson JL, Peterson BL (2006) Major depression and physical illness trajectories in heart failure and pulmonary disease. J Nerv Ment Dis 194:909–916PubMedCrossRef Koenig HG, Johnson JL, Peterson BL (2006) Major depression and physical illness trajectories in heart failure and pulmonary disease. J Nerv Ment Dis 194:909–916PubMedCrossRef
20.
Zurück zum Zitat Kooy K van der, Hout H van, Marwijk H et al (2007) Depression and the risk for cardiovascular diseases: systematic review and meta analysis. Int J Geriatr Psychiatry 22:613–626PubMedCrossRef Kooy K van der, Hout H van, Marwijk H et al (2007) Depression and the risk for cardiovascular diseases: systematic review and meta analysis. Int J Geriatr Psychiatry 22:613–626PubMedCrossRef
21.
Zurück zum Zitat Lederbogen F, Kopf D, Hewer W (2008) An interdisciplinary unit for major psychiatric/somatic comorbidity: concept and 22 years of experience. Nervenarzt 79:1051–1058PubMedCrossRef Lederbogen F, Kopf D, Hewer W (2008) An interdisciplinary unit for major psychiatric/somatic comorbidity: concept and 22 years of experience. Nervenarzt 79:1051–1058PubMedCrossRef
22.
Zurück zum Zitat Lyness JM, Kim J, Tang W et al (2007) The clinical significance of subsyndromal depression in older primary care patients. Am J Geriatr Psychiatry 15:214–223PubMedCrossRef Lyness JM, Kim J, Tang W et al (2007) The clinical significance of subsyndromal depression in older primary care patients. Am J Geriatr Psychiatry 15:214–223PubMedCrossRef
23.
Zurück zum Zitat Lyness JM, Yu Q, Tang W et al (2009) Risks for depression onset in primary care elderly patients: potential targets for preventive interventions. Am J Psychiatry 166:1375–1383PubMedCrossRef Lyness JM, Yu Q, Tang W et al (2009) Risks for depression onset in primary care elderly patients: potential targets for preventive interventions. Am J Psychiatry 166:1375–1383PubMedCrossRef
24.
Zurück zum Zitat Meeks TW, Vahia IV, Lavretsky H et al (J Aff Dis 2011) A tune in „a minor“ can „b major“: a review of epidemiology, illness course, and public health implications of subthreshold depression in older adults. J Affect Disord 129:126–142 Meeks TW, Vahia IV, Lavretsky H et al (J Aff Dis 2011) A tune in „a minor“ can „b major“: a review of epidemiology, illness course, and public health implications of subthreshold depression in older adults. J Affect Disord 129:126–142
25.
Zurück zum Zitat Mehta M, Whyte E, Lenze E et al (2008) Depressive symptoms in late life: associations with apathy, resilience and disability vary between young-old and old-old. Int J Geriatr Psychiatry 23:238–243PubMedCrossRef Mehta M, Whyte E, Lenze E et al (2008) Depressive symptoms in late life: associations with apathy, resilience and disability vary between young-old and old-old. Int J Geriatr Psychiatry 23:238–243PubMedCrossRef
26.
Zurück zum Zitat Pérès K, Jagger C, Matthews FE, MRC CFAS (2008) Impact of late-life self-reported emotional problems on disability-free life expectancy: results from the MRC cognitive function and ageing study. Int J Geriatr Psychiatry 23:643–649PubMedCrossRef Pérès K, Jagger C, Matthews FE, MRC CFAS (2008) Impact of late-life self-reported emotional problems on disability-free life expectancy: results from the MRC cognitive function and ageing study. Int J Geriatr Psychiatry 23:643–649PubMedCrossRef
27.
Zurück zum Zitat Rapp MA, Schnaider-Beeri M, Wysocki M et al (2011) Cognitive decline in patients with dementia as a function of depression. Am J Geriatr Psychiatry 19:357–363PubMedCrossRef Rapp MA, Schnaider-Beeri M, Wysocki M et al (2011) Cognitive decline in patients with dementia as a function of depression. Am J Geriatr Psychiatry 19:357–363PubMedCrossRef
28.
Zurück zum Zitat Rockwood K, Mitnitski A, Song X et al (2006) Long-term risks of death and institutionalization of elderly people in relation to deficit accumulation at age 70. J Am Geriatr Soc 54:975–979PubMedCrossRef Rockwood K, Mitnitski A, Song X et al (2006) Long-term risks of death and institutionalization of elderly people in relation to deficit accumulation at age 70. J Am Geriatr Soc 54:975–979PubMedCrossRef
29.
Zurück zum Zitat Rockwood K, Song X, Mitnitski A (2011) Changes in relative fitness and frailty across the adult lifespan: evidence from the Canadian National Population Health Survey. CMAJ 183:E487–E494PubMed Rockwood K, Song X, Mitnitski A (2011) Changes in relative fitness and frailty across the adult lifespan: evidence from the Canadian National Population Health Survey. CMAJ 183:E487–E494PubMed
30.
Zurück zum Zitat Schoevers RA, Geerlings MI, Deeg DJ et al (2009) Depression and excess mortality: evidence for a dose response relation in community living elderly. Int J Geriatr Psychiatry 24:169–176PubMedCrossRef Schoevers RA, Geerlings MI, Deeg DJ et al (2009) Depression and excess mortality: evidence for a dose response relation in community living elderly. Int J Geriatr Psychiatry 24:169–176PubMedCrossRef
31.
Zurück zum Zitat Singh NA, Stavrinos TM, Scarbek Y et al (2005) A randomized controlled trial of high versus low intensity weight training versus general practitioner care for clinical depression in older adults. J Gerontol A Biol Sci Med Sci 60:768–776PubMedCrossRef Singh NA, Stavrinos TM, Scarbek Y et al (2005) A randomized controlled trial of high versus low intensity weight training versus general practitioner care for clinical depression in older adults. J Gerontol A Biol Sci Med Sci 60:768–776PubMedCrossRef
32.
Zurück zum Zitat Sumaya IC, Rienzi BM, Deegan JF 2nd, Moss DE (2001) Bright light treatment decreases depression in institutionalized older adults: a placebo-controlled crossover study. J Gerontol A Biol Sci Med Sci 56:M356–M360PubMedCrossRef Sumaya IC, Rienzi BM, Deegan JF 2nd, Moss DE (2001) Bright light treatment decreases depression in institutionalized older adults: a placebo-controlled crossover study. J Gerontol A Biol Sci Med Sci 56:M356–M360PubMedCrossRef
33.
Zurück zum Zitat Tedeschini E, Levkovitz Y, Iovieno N et al (2011) Efficacy of antidepressants for late-life depression: a meta-analysis and meta-regression of placebo-controlled randomized trials. J Clin Psychiatry 72:1660–1668PubMedCrossRef Tedeschini E, Levkovitz Y, Iovieno N et al (2011) Efficacy of antidepressants for late-life depression: a meta-analysis and meta-regression of placebo-controlled randomized trials. J Clin Psychiatry 72:1660–1668PubMedCrossRef
34.
Zurück zum Zitat Wang PS, Schneeweiss S, Brookhart MA et al (2005) Suboptimal antidepressant use in the elderly. J Clin Psychopharmacol 25:118–126PubMedCrossRef Wang PS, Schneeweiss S, Brookhart MA et al (2005) Suboptimal antidepressant use in the elderly. J Clin Psychopharmacol 25:118–126PubMedCrossRef
35.
Zurück zum Zitat Weyerer S, Bickel H (2007) Epidemiologie psychischer Erkrankungen im höheren Lebensalter. Grundriss Gerontologie, Bd 14. Kohlhammer, Stuttgart Weyerer S, Bickel H (2007) Epidemiologie psychischer Erkrankungen im höheren Lebensalter. Grundriss Gerontologie, Bd 14. Kohlhammer, Stuttgart
36.
Zurück zum Zitat Whang W, Shimbo D, Kronish IM et al (2010) Depressive symptoms and all-cause mortality in unstable angina pectoris (from the Coronary Psychosocial Evaluation Studies [COPES]). Am J Cardiol 106:1104–1107PubMedCrossRef Whang W, Shimbo D, Kronish IM et al (2010) Depressive symptoms and all-cause mortality in unstable angina pectoris (from the Coronary Psychosocial Evaluation Studies [COPES]). Am J Cardiol 106:1104–1107PubMedCrossRef
37.
Zurück zum Zitat Yesavage JA, Brink TL, Rose TL et al (1982) Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 17:37–49PubMedCrossRef Yesavage JA, Brink TL, Rose TL et al (1982) Development and validation of a geriatric depression screening scale: a preliminary report. J Psychiatr Res 17:37–49PubMedCrossRef
38.
Zurück zum Zitat Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67:361–370PubMedCrossRef Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67:361–370PubMedCrossRef
Metadaten
Titel
Depression beim gebrechlichen Alterspatienten
Diagnostik und Therapie
verfasst von
D. Kopf
J. Hummel
Publikationsdatum
01.02.2013
Verlag
Springer-Verlag
Erschienen in
Zeitschrift für Gerontologie und Geriatrie / Ausgabe 2/2013
Print ISSN: 0948-6704
Elektronische ISSN: 1435-1269
DOI
https://doi.org/10.1007/s00391-012-0461-9

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